r/depressionregimens

Well, SSRI's don't seem to be working for me at all. Anyone have success on an SNRI vs an SSRI?

My friend was prescribed 80 mg of paroxetine and 200 mg of fluvoxamine for anxiety and OCD. She's been taking them for about a year. She recently went to see a doctor because she's been losing a lot of weight. Her liver enzymes were extremely high. Using two drugs from the same class at such high doses together seems ridiculous.

What do you think? Are there others who use similar drug combinations? Thank you

Hello everyone,

I am still here, still struggling, still fighting. I want to live, I want my life back, I just don't want to feel like this.

While I do believe my issue is perhaps more related to OCD/Extreme anxiety, always in flight or fight, hypervigilance, it causes me to be depressed/hopeless because I HATE feeling like this and am scared I will forever feel like this and lose control of my life. It is constant, constant, constant intrusive thoughts of death, intrusive suicidal thoughts. I am still 5 months post-partum but I just want relief. I manage to function every day like get up, shower, take care of my beautiful kids, go to work (cannot focus for the life of me), cook dinner, and clean, work out 4-5 days as week. My sleep sucks, I toss and turn every 30 minutes, I do not get deep sleep, I feel like my brain is awake even when I am sleeping. From the outside I look normal, but I am deeply suffering. It's like I battle my brain every minute: One minute it says "Ok I'll get through this there is hope", and the next minute its hopeless, ready to check myself in somewhere.

To recap- I fortunately never had anxiety/depression issues until I went through back-to-back pregnancy losses in late 2021. It's like something glitched my brain.

I have tried Zoloft, Clomipramine, Trazadone, now Lexapro and lamotrigine. I started Lexapro the end of January and started Lamotrigine in early April. Is it even worth to try more meds? Has anyone tried many meds that failed, then finally found something that worked? I am truly beginning to worry that I am medication resistant.

Please offer any insight.

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St John's Wort and Passionflower 400mg b.i.d put my depression into remission for around a year and a half. I remember weeping tears of joy when I began feeling a clarity of mind and depth of emotion I hadn't had in years after the herb reached full effect.

Recently I have had to start another medicine which significantly interacts with above and have gone to my GP to try two synthetic drugs so far. Sertraline 50mg sedated me to the point where I couldn't get out of bed, and fluoxetine at 20mg 'worked', while robbing me of all emotion and making me extremely sedated. Fluoxetine at 10mg had some antidepressant activity with little sedation, but nothing as effective as St John's Wort.

Now, on nothing, I am depressed to the point where it is genuinely painful. I've been prescribed venlafaxine to try this week. Reading that its NET inhibition is very mild I have doubts.

I'm irritated at my GP who won't prescribe bupropion because it isn't licenced for depression in Ireland despite carrying significant evidence. It seems reasonable to me that serotonin reuptake alone isn't enough to put my depression into remission, and SJW is understood to be a broad-spectrum reuptaker.

I'm genuinely peeved at the stupidity of the process. Having been on multiple meds now I can distinguish between low mood and depression. SJW treats both, fluoxetine only treats the latter. Both are awful but one isn't necessarily worse than the other. Bupropion from my research significantly raises mood, being an NDRI.

I'm peeved also at the medical industry which has two dozen SSRIs for every NRI/NDRI/SNDRI. Anhedonia, sedation and sexual stunting are widespread side effects of exclusive serotonin modulation, and pills from the 90s with very poor remission rates are still pushed as first-line medicines contrary to the burden of evidence.

ChatGPT tells me bupropion at 150mg o/d and fluoxetine/venlafaxine at standard or sub-standard dose might come close to mimicking SJW and I'm inclined to agree with it. This seems to be a reasonable and safe intervention but my GP won't agree to it because Irish antidepressant guidelines seem to be stupid and antiquated.

More of a rant than anything else, curious to read of anyone else's experience.

Anhedonia is one of the core symptoms of major depression, as we know. For you, if you remember, life with anhedonia and life without anhedonia, what were the main things that affected your life? When textbooks say lack of interest what does it mean? Can it be lack of interest in intimacy, relationships, marriage? Or is it just lack of interest in daily life activities?

I have MDD with anhedonia. I have lack of taste in foods, lack of interest in anything related to relationships, social activities, lack of joy in general.

I currently on Venlafaxine 225mg, Amoxapine 200mg, Trazodone 50mg and Prazosin 2.5mg. Hoping to find a medicine combo that brings my life back to normal.

Like the title says. I recently went down to 150 mg after being on 300 mg for years. The reason I went down to 150 mg was just because 300 mg started to overstimulate me in various ways and caused some weird side effects I didn’t use to get before or to this extent. It became almost impossible for me to function on a daily basis just because of the physical symptoms of anxiety, terrible insomnia and sleep disturbances it caused. Even though 300 mg worked tremendously for my SCT, executive dysfunction, energy, motivation, cognition and depression. The massive anxiety and all these other side effects that I got, which seemed to be clearly related to its noradrenergic effects and those side effects were frequent thirst, frequent urination, dizziness, vertigo, headaches, hot flashes, burning sensations, insomnia, jitteriness, hyper vigilance, heart palpitations, rapid heartbeat, fast bowel movements, you name it. Made me back off the dose with my psych’s suggestion.

Now it’s been four days since I started the 150 mg dose and I’m already noticing my depression is slowly starting to come back all over again and my SCT and executive dysfunction is starting to plummet all over again. I have no energy or motivation to do anything and I feel so lazy and I just don’t want to do anything anymore. My cognition is significantly worse. Mental clarity and brain fog has significantly worsened too. It’s like everything has gotten worse since I lowered the dose. The only thing I’m noticing since lowering the dose that I’m much less anxious, my sleep has gotten much better too and that the side effects I had before have pretty much resolved and almost disappeared. And I feel quite relived because of that. So lowering the dose did something.

But also since lowering the dose I’ve also noticed that I have more mood swings and I’ve had several anger and emotional outbursts. The racing and the negative thoughts have also started to come back all over again. And I’ve felt extremely suicidal these last four days. It’s not like I’m thinking about planning on doing it and going through with it. But it’s like I’ve had this feeling of wanting to die because I feel so unable to function properly and I have this depressive shutdown right now. Taking 150 mg feels almost like a sugar pill to me and so far it doesn’t seem to be doing anything for me. It’s not going too well for me right now.

I just don’t know what to do anymore. 300 mg handled my depression very well for a long time, but made my anxiety worse over time all by itself. 150 mg doesn’t seem to be doing anything so far. When I used to take 300 mg Wellbutrin and 20 mg Prozac in the past I had none of those side effects I’ve mentioned. I just want to hear your thoughts and opinions about this. I really need some advice right now on what to do?

Generally docs follow some sort of trial and error method (algorithm) to help find the right med for you. That doesn't mean that you have to try all SSRIs first and only then you can move onto a different class. Here doc experience comes to play.

But has it happened with anyone that after trying a few meds from different classes you come back to, say one SSRI you didn't trial before and it worked? Is it possible?

Because it is common wisdom that although all SSRIs, SNRIs or TCAs are classified like that not all medicines under one class are equal. Even it varies person to person.

I was thinking of making a list of antidepressants from best to worst. I’ve been searching online for people sharing their opinions and saying which antidepressant worked best and worst for them. Right now I’ve been on clomipramine for three weeks, so we’ll see what happens later.. :D

M35, For years im on trial and errors with antidepressants, just nothing.

I've never felt what does focus means, 24/7 scattered brain and tons of thoughts at the same time, can't finish anything or complete a task, extremely easy to be distracted and terribly non available memory.

which completely affected my life so bad, i can't learn or memorize anything, can't study, working in a terrible place because i couldn't find better due to my issues and im the only one at work that always distracted, never completed a task and the only one that always forgets and makes mistakes, even the simplest math i can't do.

Tried the first route, lab tests are fine, vitamins, minerals, herbal extracts and amino acids but nothing worked.

Doctors just say its some kind of anxiety and stress.

Then finally went to psychiatrists, started with SSRI'S, SNRI'S and Tricyclic antidepressants and to be honest, they just killed my last cells of emotions and made me eat more, That made me hold still from 2019 till now and made me feel so depressed all the time and this loop cycle is still running til now.

Trials and errors with Fluvoxamine, fluoxetine, Venlafaxine, olanzipine, welbutrin, paroxetine, Cymbalta and Clomipramine.

Lastly im on 20mg Prozac and 150mg Clomipramine.

Doctors just says medications needs time and i hear that from 2019 to this moment.

Tried to research and to see what's going on and god knows how hard that was and found ADHD which i can relate to 100% of it (ADD) Thanks to the internet and reddit.

Went to psychiatrists again and what I've found that where i live ADHD is something like witchcraft and got terrified from doctors warnings from using stimulants.

But i don't know what to do to help myself, I'm a father of 2 kids and i don't want to complete my life like this.

Please advice, I've an appointment with my psychiatrist in the next week and don't know what to do

I know that Clomipramine is a TCA antidepressants but it is also the most potent SNRI's available on the market , after being on 75mg for 4 weeks , bumped to 112.5mg last week and my energy levels are finally back to baseline ( I had sever chronic fatigue due to my depression ) , my anxiety is also very manageable and my thoughts are so quiet for god remembers how long ... , my derealization is much better too

All in allw Clomipramine is a very succes to me after trying over 20meds over the course of 5 years .

I am also on olanzapine 5mg ( instead of Seroquel 300mg wich made me a zombie 24/7 ) , olanzapine is really good so far at 5mg , Depakote 500mgx2 , and lastly Tianeptine 12.5mg x 3 a day and 50mg Amisulpride for major depression .

This combo is really bringing me back to life after years in a dark hole ...

Whats ur experience guys with clomipramine ?

Has TMS been successful for anyone? I hear mixed things but considering it in the near future.

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It's like an alien language to me. Now granted I've been actively suicidal for a number of years and I would like to just turn the lights off so to speak. My current treatment program has greatly reduced that aspect of my personality.

The problem is I do not like myself and I don't have any sense of an inner person. Who I am is something I can't answer, I don't have much sense of an inner dialog. I have people who care about me, and I just don't get it. They would all be better off if I were not present, but for whatever reason they take some joy from my presence.

At best I can "not think" about myself and just do a thing, but thinking about who I am, what I do, where I've been, what I've done... I just don't care about that guy. Don't like him.

So explain it to me like I'm from another world because I can't wrap my head around it.

M35, For years i was suffering from GAD, Agoraphobia, Depression, unavailable focus with scattered thoughts and can't learn or memorize anything.

In the beginning doctors prescribed fluvoxamine then paroxetine then Venlafaxine then olanzipine and now 20mg Prozac with 150mg Clomipramine at night.

These trials and errors with meditations and dosages took years from 2019 to finally settle on 20mg Prozac and 150mg Clomipramine but finally able to get a job.

But i couldn't focus, fatigued most of the time, can't learn or memorize anything, still depressed, self esteem destroyed, no confidence, stutter sometimes, even couldn't do the simplest math without calculator and terrible social skills..

Last 2 years i discovered reddit and start researching, tried tons of supplements and felt nothing, vitamins, minerals, herbal extracts, amino acids just nothing worked out the blood work came fine on papers.

until by luck got a 500mg Citicoline from a local pharmacy and luckily felt something.

finally started to talk with customers, some motivation and energy, 2 weeks later got some Armodafinil 150mg and Quatrefolic folate and my brain switch turned on.

Talking alot with customers, extroverted, confidence through the roof, playing with my kids, calm and relaxed.

Yes i felt my heart a bit racing, some headaches,

Maybe my focus is still not there and didn't feel anything positive regarding memory and learning.

But this is like a miracle to me, specifically Armodafinil.

So i came here to ask for more help please,

Did doctors prescribed the wrong antidepressants for me all these years SSRI'S, SNRI'S and Tricyclics.

Nothing came even close to this last experience.

I've an appointment with the psychiatrist soon but i don't know what to say.

Sorry for my terrible English.